2.5.7 Refugee Medical Assistance

Refugee Medical Assistance (RMA) is a federally funded Office of Refugee Resettlement (ORR) program that provides health care coverage for the first 12 months for certain noncitizens who are otherwise ineligible for Medical Assistance (MA).

To qualify for RMA, applicants must meet the following conditions:

Be ineligible for MA.
Have an ORR-eligible immigration status or classification.
Provide the name of their resettlement agency to the county human services agency, if applicable.
Meet RMA financial eligibility criteria.
Are not a full-time student in an institution of higher learning.
Be within the RMA12-month eligibility period, or requesting coverage for medical bill accrued during that period.
Reside in Minnesota.

Agencies must follow the ONEsource. instructions, “Process a Referral or Application for Refugee Medical Assistance,” when a person attesting to an ORR-eligible immigration status is determined ineligible for MA and is within the 12-month RMA eligibility period.

Social Security Number

RMA applicants and enrollees are not required to apply for or provide SSNs.

Non-Financial Eligibility

Immigration Status

Noncitizens with the following ORR-eligible immigration statuses or classifications are eligible for RMA if they meet all other eligibility factors:

Refugees
Asylees (people granted asylum)
Certified Victims of Human Trafficking
Iraqi and Afghan Special Immigrant Visa holders
Certain Amerasians from Vietnam
Cuban and Haitian Entrants
Certain Afghan Humanitarian Parolees
Certain Ukrainian Humanitarian Parolees

People who adjusted to LPR or are an LPR upon gaining status from any of the above statuses or classifications, and meet the following criteria, may be eligible for RMA if they are not eligible for MA:

Still within the 12-month eligibility period, and
Meet all RMA program requirements

RMA 12-month Eligibility Period

The RMA 12-month period of eligibility is the maximum length of time a person can qualify for RMA.

The first month of the RMA 12-month period of eligibility is the earlier of either:

the date the person enters the United States with ORR-eligible immigration status, or
the date the person is granted ORR-eligible immigration status or classification.

The RMA 12-month period of eligibility ends on the last day of the 12th month.

The RMA 12-month eligibility period runs consecutively through the 12 months without pause, even if the person is not active on RMA. A change in state residency does not restart the eligibility period.

Financial Eligibility

Income Limit

To be eligible for RMA a person’s household income must be less than or equal to 200% of federal poverty guidelines (FPG).

Use only actual income received at initial application. Do not average the income prospectively over the eligibility period. The actual income amount is used throughout the RMA eligibility period.

When income increases after the initial RMA application is approved, the enrollee remains eligible for the remainder of the 12-month RMA period.

When an MA enrollee loses MA due to an income increase and is still within the RMA 12-month eligibility period, the enrollee must be determined for RMA without the income being considered for the remainder of the RMA 12-month period.

Asset Limit

The asset limit for RMA is eligibility is:

$10,000 for a household of 1.
$20,000 for a household of 2 or more.

RMA follows the same asset methodology as MA-FCA with a spenddown. See EPM 2.2.3.6 MA-FCA Medical Spenddown for more information.

Sponsor deeming does not apply to RMA enrollees. Noncitizens with ORR-eligible immigration statuses or classifications are exempt from Form I-864 Sponsorship, so they are not subject to sponsorship or sponsor deeming.

Eligibility Begin Date

RMA eligibility begins on the date of application if the person meets all financial and non-financial eligibility factors.

If a person requests retroactive RMA coverage, it can go back up to 3 months from the date of the application, if there was a medical need during that timeframe. This retroactive coverage request cannot begin earlier than:

the date the person enters the United States with ORR-eligible immigration status, or
the date the person is granted ORR-eligible immigration status or classification.

Follow EPM 1.4 State Residency, Overlapping State Coverage, when the applicant has coverage in another state.

Eligibility End Date

RMA eligibility must end on the last day of the 12-month RMA period. If RMA ends for reasons other than income, RMA must be closed on the last day of the month, allowing a 10-day adverse action notice.

Eligibility must be redetermined for other health care programs such as Medical Assistance, MinnesotaCare, Advanced Premium Tax Credits, or a Qualified Health Plan.

An enrollee must receive at least 10-day advance notice of any adverse change to their RMA eligibility. See EPM 1.3.2.1 MHCP Change in Circumstance for more information.

Health Care Delivery

RMA enrollees receive their benefits via fee-for-service. Fee-for-service is a method of payment for health care services used for enrollees not in a managed care plan. See MHCP Health Care Delivery for more information.

Legal Citations:

Code of Federal Regulations, title 45, subtitle B, Chapter IV, Part 400, Subpart G

Code of Federal Regulations, title 42, Chapter IV, subchapter C, part 440